Healthcare Provider Details

I. General information

NPI: 1285568014
Provider Name (Legal Business Name): OLIVIA KEENLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 HIGH ST
SEAFORD DE
19973-3923
US

IV. Provider business mailing address

26917 WOOD DUCK RD
MILLSBORO DE
19966-6198
US

V. Phone/Fax

Practice location:
  • Phone: 302-394-6051
  • Fax:
Mailing address:
  • Phone: 540-935-9955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: